EC Neurology

Corona virus disease 2019 (COVID-19) has infected a great number of patients with a pandemic behavior in the world and therefore even rare manifestations of the virus infection have been reported during a short period of time. Corona viruses have special neurotropic potential with neurological complications occurring both in central nervous and peripheral nervous systems [1]. Neurological manifestations occur in up to 36.5% of COVID-19 infected patients [2]; Guillain-Barré syndrome (GBS) accounts for 1.4% of the reported [1]. Para-infectious immune mediated mechanism is thought to be the underlying cause of GBS in COVID-19 disease [3,4]. It is however shown that neurological complications occur in severe cases of COVID-19 infection [2]. GBS in the setting of COVID-19 can contribute to respiratory failure. High level of suspicion and in particular when the patient has lost the consciousness is therefore critical. On the other hand proper diagnosis and treatment of GBS can help better controlling respiratory insufficiency.

We have been consulted for we a 47 year old woman with several days of cough and generalized body pain and low grade fever infected with COVID-19 and admitted to internal medicine. She had past medical histories of diabetes mellitus, hypothyroidism, hyperlipidemia, ischemic heart disease and hypertension. Along with typical chest CT for COVID-19, treatment with anti COVID-19 medications (Table 1) was started for her (Figure 1). After one week of treatment, her respiratory condition deteriorated and lead to intubation and mechanical ventilation. During treatment with mechanical ventilation and on third week of therapy for COVID-19, quadriparesis with loss of tendon reflex with preserved function of cranial nerve innervated muscles.

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